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Specificity theory legitimizes the analyst's attempts to tailor the treatment process to improve its efficacy. It recognizes that the analyst's responsiveness effectively draws upon a rich palette of both verbal and nonverbal interventions for therapeutic relating. Dispensing with the notion of analytic neutrality, specificity theory recognizes that each therapist offers something therapeutically unique to a particular patient, which includes but also transcends both theory and technique, encompassing who the therapist is as an individual in innumerable respects. It requires that the therapeutic engagement be continually monitored and adjusted to fit the changing capacities and limitations of the particular therapeutic dyad. The principles of specificity theory are suitable to be used by therapists of different theoretical backgrounds-and further, can be applied as an overarching principle functioning to integrate diverse theoretical approaches.Howard Bacal introduced the term optimal responsiveness in 1985, when it was becoming imperative that analysts make significant adjustments to the psychoanalytic theory of the therapeutic process. The widespread attempts to work with patients who were inaccessible to standard analytic treatment required a theory that incorporated the therapeutic aspects of a more modified analytic technique. In answer to the emphasis of some clinicians on neutrality, insight, and frustration of the patient, Bacal developed an idea that was inclusive of many interventions that were not being formally discussed among professionals. Since then, he has revised and refined the concept of optimal responsiveness and has identified specificity theory as the theoretical perspective that underlies it.In the present climate of increased tolerance and integration of diverse theoretical ideas by the analytic community, the use of optimal responsiveness as an overall clinical posture is especially germane. This is because the principle of optimal responsiveness can be used by therapists who may already be working in similar ways despite coming from

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up 49 out of 76 patients who had been on the waiting list for psychotherapy for three to seven years but had not received treatment. (Seven patients who had found treatment elsewhere in the meantime were excluded.) 65 per cent. were found to be â€oe¿ recovered― or â€oe¿ improved―. Criteria were: â€oe¿ Recovered: these were symptom free and in full employment, and had suffered no loss in socioeconomic status. Improved: these were troubled only by residual symptoms, were in full employment, and had suffered no loss in socioeconomic status.― (c) Saslow and Peters (5956) followed up 87 out of ioo consecutive patients who had been diagnosed as â€oe¿ behaviour disorder― andâ€"for any reasonâ€"had not had more than two interviews. Follow-up was one to seven years. Criteria used were those of Miles, Barrabee and Finesinger (595 i). @ per cent. were â€oe¿ apparently recovered― to â€oe¿ improved―. This study is rendered less valuable by the statement that 53 per cent. of the patients had had â€oe¿ continuous care of some kind― (nature not stated) since their original interview. 2. The second type of study is that in which untreated controls are compared with treated patients, or in which â€oe¿ less treated― or â€oe¿ less specifi cally treated― patients are compared with those who were â€oe¿ more treated―. The evidence from this type of study is equivocal. Studies in which little significant difference could be found between the two series are: (a) Barron and Leary (i@@@; criteria: changes in the M.M.P.I.; follow-up 7â€"8 months); (b) Brill (1966; criteria: M.M.P.I., clinical evaluation; follow-up about two years). This study contained a series of patients who were put on a waiting list but in fact never received treatment. (c) Endicott and Endicott (1963, and in press; criteria: many psychological tests, including M.M.P.I., and many clinical rating scales; follow-up 6 months for the waiting list controls). Studies in which significantly more improve ment was found in the treated patients were: (a) Rogers and Dymond (sg@; criteria: self * This includes Case i i, whose original complaint (vocational problems) had disappeared, though the word â€oe¿ symptom― is perhaps not entirely appropriate.